Texas lawmakers have until midnight on Thursday to negotiate a deal on the 2014–2015 state budget before the current legislative session ends. But they may find themselves in town for a bit longer if some Tea Party lawmakers in the state House have their way and force a special legislative session over a Republican-backed rider regarding Obamacare’s Medicaid expansion — even though the amendment wouldn’t actually expand Texas’ Medicaid program, but simply “open the door to discussions with the federal government to expand health care coverage for the state’s poorest adults.”
The threats from Texas Tea Partiers make it even more unlikely than it already was that the Lone Star State will pass anything resembling a Medicaid expansion — or even future promises to simply talk about the issue — this year. As Texas Republicans — who introduced the rider — point out, the provision is simply a declaration that state and federal officials will discuss how to help the state’s poorest residents gain coverage in a way that hews to conservative, “free market principles” regarding health entitlements in light of upcoming cuts to safety net hospitals and Texas’ massive poor and uninsured population. But those arguments have failed to sway some in the Tea Party caucus, who view any talk of Medicaid at all as a sell-out to President Obama’s landmark health reform law:
“If the budget expanded Medicaid, conservatives in the House would vote the budget down,” said state Rep. Van Taylor, a Tea Party favorite from Plano. He said conservative Republican members of the House are “absolutely prepared to go to the mat” and return for multiple special sessions to prevent any semblance of Medicaid expansion.
State Rep. John Zerwas, R-Simonton, said House Bill 3791, which he filed to present the Legislature with an alternative way to expand health coverage to the state’s poorest adults without expanding Medicaid, would probably not move out of the lower chamber by the House’s midnight Thursday deadline, therefore the rider was one of few — if not the only — remaining legislative vehicles for the Legislature to weigh in on the issue.
“If people took the time to read the rider they would recognize that it’s not a Medicaid expansion,” he said. “They would understand clearly that it is a lot of, frankly, conservative principles.”
In fact, HB 3791 — a GOP alternative to Obamacare’s Medicaid expansion that would have covered Texas’ poorest by giving them subsidies to buy private insurance — was already doomed to fail in the House. This rider is simply a last resort that promises future negotiations on the issue. It actually also endorses extremely regressive approaches to expanding the safety net, including possibly block-granting the state’s Medicaid program. But, as the debate over Obamacare has become increasingly disconnected from reality, some members of the Texas Tea Party are willing to hold the state’s entire budget hostage over a measure endorsing policies that they have historically supported.
While this recent infighting is something of a new low in the Medicaid expansion debate, GOP hypocrisy regarding the health reform law certainly isn’t. Receiving federal funding in exchange for expanding and privatizing Medicaid programs — which the Obama Administration has signed onto — is usually a GOP-endorsed policy. In fact, Texas Gov. Rick Perry (R) struck a massive deal with federal officials in 2011 allowing him to move close to a million Medicaid beneficiaries into private, managed care. Perry heralded the move at the time, but has refused to accept an expanded version that same deal now that it’s a priority for the Administration and necessary for effective Obamacare implementation.
Only 35 percent of Texans living below 139 percent of the Federal Poverty Line (FPL) are covered by the state’s Medicaid program. 43 percent are uninsured.